What is the most critical check when assessing for altered mental status in a child?

When assessing for altered mental status in a child, the most critical check is the blood sugar level. This is crucial because hypoglycemia (low blood sugar) can rapidly lead to altered mental status and may present with symptoms such as confusion, irritability, lethargy, or even loss of consciousness. Since children often have varying metabolic demands and can become hypoglycemic more quickly than adults, it is essential to rule out abnormal blood sugar levels as a potential cause for any changes in consciousness or behavior.

Learning to identify and address hypoglycemia can be life-saving and ensures that appropriate interventions can be implemented to stabilize the child. The other checks, while important in their own right, may not be as immediately critical in the context of altered mental status. For instance, blood pressure can indicate circulatory concerns, neurological reflexes can provide information about neurological function, and temperature can indicate infection or other conditions, but addressing blood sugar levels is pivotal for immediate recovery and management.